Why is the ACA (Obamacare) so complicated?

With the ACA (“Obamacare”) so much in the news, I thought I’d answer the obvious question — why is it so complicated?

I could offer a number of my own explanations, but there’s none better than Ari Berman’s. Writing at The Nation in the summer prior to the 2012 election, Berman profiles Jim Messina, Obama’s then-campaign manager.

It turns out that Messina was also the architect of Obama’s ACA legislative strategy. In a piece called “Jim Messina, Obama’s Enforcer” Berman writes about the passage of the ACA. It explains all you need to know, about the ACA, Jim Messina, and yes, his boss (Obama) as well. (If you want to jump to fixing Obamacare, go here.)

Let’s start with some context on Messina. Berman opens (my paragraphing and some emphasis below):

Jim Messina, Obama’s Enforcer

In March 2009 the Campaign for America’s Future, a top progressive group in Washington, launched a campaign called “Dog The (Blue) Dogs” to pressure conservative Blue Dog Democrats to support President Obama’s budget. When he heard about the effort, White House deputy chief of staff Jim Messina, who was regarded as the Obama administration’s designated “fixer,” called CAF’s leaders into the White House for a dressing down, according to a CAF official.

If the group wanted to join the Common Purpose Project, an exclusive weekly strategy meeting between progressive groups and administration officials, CAF had to drop the campaign. We know how to handle the Blue Dogs better than you do, Messina said.

Not wanting to sour its relationship with the White House at this early date, CAF complied, and the campaign quickly disappeared from its website. Despite Messina’s assurance, however, the Blue Dogs would remain a major obstacle to the realization of the president’s legislative agenda.

The hardball tactics used by Messina against CAF exemplified how the Obama administration would operate going forward—insistent on demanding total control, hostile to any public pressure from progressives on dissident Democrats or administration allies, committed to working the system inside Washington rather than changing it. … “It was a major harbinger to me, when Obama hired him, that we were not going to get ‘change we can believe in,’” says Ken Toole, a former Democratic state senator and public service commissioner in Montana [Messina’s home state, where he worked for Senator Max Baucus].

That sets the stage and tells you a lot about Obama’s relationship with progressives, and Messina’s as well. As Berman elsewhere notes, the “Common Purpose Project” was what Jane Hamsher called the “veal pen,” a weekly meeting in which progressive organizations were wrangled (or bullied) to support administration policy goals instead of their own.

Now about the ACA:

At the beginning of the healthcare debate in 2009, many Democrats were justifiably concerned about the role that [Max] Baucus, chair of the powerful Finance Committee, would play in shepherding the Obama administration’s domestic policy priority through the Senate. Baucus had brokered the passage of George W. Bush’s 2001 tax cuts and 2003 Medicare prescription drug plan, and had spent the better part of the Bush presidency cutting deals with Republicans and infuriating fellow Democrats. …

Among Senate Democrats, only Nebraska’s Ben Nelson had a more conservative voting record on economic issues than Baucus. Moreover, Baucus accepted the most special-interest money of any senator between 1999 and 2005, and had at least two dozen staffers working as lobbyists on K Street, including for healthcare companies adamantly opposed to reform.

Despite these obvious warning signs, Messina emerged as the leading advocate for his old boss during the healthcare debate and the top administration conduit to his office. … Messina told the Washington Post heregarded Baucus as a father figure. …

The administration deputized Messina as the top liaison to the Common Purpose Project. … During the healthcare fight, Messina used his influence to try to stifle any criticism of Baucus or lobbying by progressive groups that was out of sync with the administration’s agenda, according to Common Purpose participants.

“Messina wouldn’t tolerate us trying to lobby to improve the bill,” says Richard Kirsch, former national campaign manager for Health Care for America Now (HCAN), the major coalition of progressive groups backing reform. Kirsch recalled being told by a White House insider that when asked what the administration’s “inside/outside strategy” was for passing healthcare reform, Messina replied, “There is no outside strategy.”

The inside strategy pursued by Messina, relying on industry lobbyists and senior legislators to advance the bill, was directly counter to the promise of the 2008 Obama campaign, which talked endlessly about mobilizing grassroots support to bring fundamental change to Washington.

But that wasn’t Messina’s style—instead, he spearheaded the administration’s deals with doctors, hospitals and drug companies, particularly the Pharmaceutical Research and Manufacturers of America (PhRMA), one of the most egregious aspects of the bill. “They cared more about their relationship with the healthcare industry than anyone else,” says one former HCAN staffer. “It was shocking to see. To me, that was the scariest part of it, because this White House had ridden in on a white horse and said, ‘We’re not going to do this anymore.’”

When they were negotiating special deals with industry, Messina and Baucus chief of staff Jon Selib were also pushing major healthcare companies and trade associations to pour millions of dollars into TV ads defending the bill. …

I’ve cut liberally from that section so as not to quote too much, and there’s much more there. The whole piece is worth your time, but the ACA part starting with the phrase “At the beginning of the healthcare debate” is especially timely. Please do click through.

So why is the ACA is so complicated? Because the only customers that Obama, Messina and Max Baucus listened to during the entire process were “doctors, hospitals and drug companies, particularly the Pharmaceutical Research and Manufacturers of America (PhRMA),” not to mention the for-profit health insurance industry itself. Not progressives, including House progressives, and not the grassroots base. Just the industries.

A public program that serves mainly private interests has to be complicated, if it wants to appear to be a public program. Once you decide on a Clintonian privatized plan, the only way to obscure your goal is complication. Otherwise, it’s just private insurance.

Fixing the ACA (“Obamacare”) from the left

This also explains why we have to fix the ACA from the left. What does “fix it from the left mean”? In my mind it starts with at least these two initiatives:

■ Offer Medicare as an option to ACA (Obamacare) customers.

■ End the health insurance industry’s exemption from anti-trust laws (yes, they’re exempt, and it’s the source of many of their abuses, like being able to lie in advertising).

At the moment, ACA and Medicare are competitors for the same people — U.S. health insurance customers. At some point one will encroach on the other’s territory and take over the other’s market. The for-profit health insurance industry would love to get at Medicare recipients. What greedy CEO (sorry, shareholder-minded job-creator) wouldn’t?

Whose side of that equation do you think Obama is on, yours or the industry’s? I’m guessing the industry’s. Whose side are you on? I’m guessing your own.

Care to help? Care to help today? Call your congressperson, while this is still news, and ask for a “Medicare option” now. Believe me, this is being discussed in many congressional offices. Senate phone numbers here. House phone numbers here. And thanks.

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They refused the money because, if I’m not mistaken, the feds will kick in for 3 years to help defray the costs of new medicare patients and then the state is on its own and has to pay for the program itself. A recipe for disaster and bankruptcy.

Bruce

Hey, “public guy”; howzabout at least toll free #’s for Congress, or preferably a petition or e-mail campaign point? Otherwise YOU’RE causing more CO$T and consternation for US; on top of the Faucus/Obamanable PPCACA maze!
v

None of them cover the Trans Pacific Partnership pact with the exception of Ed Schultz radio program. I assume NBC doesn’t permit Schultz to discuss TPP at MSNBC.

Bill_Perdue

Still stealing it.

http://adgitadiaries.com/ karmanot

Oh, I know……You are not Rand Paul—-that’s my story and I’m sticking with it! :-)

ezpz

Please see my reply to karmanot above (or below?)

ezpz

I wasn’t trying to take credit for the word. Since it’s a widely known and oft repeated word, I didn’t think attribution was necessary. Besides, I didn’t know its origins. Now I do. Thanks. :-)
(Actually, I think I first saw it used by Griffon, former and much missed commenter here.)

http://adgitadiaries.com/ karmanot

A stitch in time! :-)

http://adgitadiaries.com/ karmanot

We can thank Paul Craig Roberts for that! :-)

emjayay

Its name is PPACA. They named it Obamacare so when they sabotaged it the blame would fall on the hated one. And because they had already painted Obama as the foreign born illegitimate socialist dictator who wants big government to control your life.

Drew2u

I got some help earlier today and I’ll find out on Monday what my next step is!
Thanks for pointing out the difference between care/caid; I was thinking of social security benefits, actually (so off base on that one, as well). I hope I got all the cares out ;p

emjayay

Senators do not have districts. They represent the whole state. Representatives have districts, and they are the ones you contact for help. Sometimes districts change as populations change, or Republicans gerrymander them. I guess if you are in some moron’s district you would get crappy service on an issue like this.

emjayay

No, Medicare has nothing to do with your health, only your age. It’s only people 65 and older. And your original post still erroneously says Medicare several times. I knew what you meant though. And I have no idea what people in states that sabotoged the ACA every way they could because the Supreme Court said they could, whose incomes are in the theoretical Medicaid range which is below ACA, are supposed to do. You would think they would just be allowed to sign up for an ACA plan and get the maximum subsidy, but I don’t think that’s the case.

emjayay

I haven’t ever seen any discussion of what younger than 65 people would pay for Medicare coverage if the age were to be extended downward. Unless a VAT tax or something like that was used to support it, obviously it wouldn’t cost $105 a month. I don’t even know what the premiums for Medicare to current recipients would be without government funding.
I’m not arguing against the idea at all. Canada for example has something like Medicare for everyone. I think it’s even called Medicare. I would prefer one tax subsidised system for everyone, and something a lot simpler, like other countries. By using some such system you for example avoid all the ACA lower income subsidy sliding scale stuff, because it does the same thing in effect. Assuming progressive taxation.

Kol Khara

After the Soviet Union collapsed, we imported their unemployed bureaucrats.

Kol Khara

Well it certainly has nothing to do with former health insurance lobbyists that wrote the legislation and then went back to lobbying for the health insurance industry.

Drew2u

Sorry, it’s just Medicaid. I’m too healthy for Medicare, lol
Really, I’m just sort of learning the terms used in insurance and the Health industry, so my apologies. I’ve edited the post accordingly.

Badgerite

I thought to ask them on the website and that is correct. But the insurance companies can give you information and help you fill out forms. The application process can be done by paper or by phone and you still qualify for subsidies. I believe.

Badgerite

I’m all for the French system. Now you go ahead and get it through the American Congress. That is what I meant by ‘you get the sausage you can afford.’ Not the cost.

eggroll_jr

One very doable option is to lower the Medicare eligibility age to 55. This idea of conflating employment and retirement age is damaging. Ask any self-employed 60-year-old with cancer or heart trouble. Moreover, some 5% of the entire US population generates 50% of health costs, so you bring under management a cohort with more than its fair share of chronic ailments. A second rule I would insist on is a nationalized dental care program for everyone under 18, with vouchers or subsidies if families prefer to use a private dentist. America’s teeth now make the legendary Brits look good. Implants, dentures, bridges, paneling, braces, these are all seen as normal activities in the US, while it gulps down energy drinks, refined sugar and HFCS, and applies teeth-whitening bleaches.

Mike_in_the_Tundra

It’s too bad that your governor is a Republican a-hole. It puts you in a horrible situation. My best advice to you is to use the emergency room as her doctor. If you’re considered a candidate for Medicaid, you don’t need to worry about any penalty for not having insurance.

In your first paragraph, you mentioned Medicare. Do you think you may be eligible for that? That would solve your problem.

Mike_in_the_Tundra

I really think that is incorrect. Your insurance will travel with you from state to state. Otherwise, driving cross-country from New York to California would be a horror story. The exchanges are just to help with purchasing.

chris10858

This is exactly what we deserve when we have an Obama Administration who walks, talks, and acts more like Ronald Reagan than a Bill Clinton.

To then further muddy the water, each state can have its own plan. So, if I move from one state to another, I have to enroll in a new plan. What happens if I had already met my yearly deductible before moving to the new state and plan?

They should have just setup one large plan for every state and it all went through the federal government. Better yet, have single payer or Medicare for All.

Drew2u

Dunno about that last part but I see this observation as the “proof” of the racism that sweeps the TeaOP. If they weren’t so stupidly racist, they could find actual true criticisms of the President, and I don’t mean things that only liberals would call a criticism (such as universal healthcare)

Bill_Perdue

Stolen.

Indigo

I don’t think he’s that good at it.

Indigo

And some really kewl art work.

Indigo

I find that fact intriguing. For all their race-bating, the Republicans have overlooked/ignored/swept under the rug some of the most valid criticisms that can be found against this presidency. One keeps wondering where the Frank Santra is in this story.

Indigo

“City of big shoulders, hog butcher for the world.”
-Carl Sandburg

cole3244

america is committing suicide and doesn’t even know it.

ezpz

Sadly, Rahmbama managed to bully and insult progressives into silence and retreat. It may take some time before they can come out from under that bus.

http://adgitadiaries.com/ karmanot

There’s not much of a left left I’m afraid.

http://adgitadiaries.com/ karmanot

Chicago has always been the stockyards of politics.

http://adgitadiaries.com/ karmanot

yep

Drew2u

No problem, the insurance commissioner is a new person to me, so I have one more person I can reach out to! (but yeah, I’m really frustrated with most of my representation)

ezpz

Hence, the word presstitutes.

cole3244

our choices are right of center & far right of center and america thinks the left are the problem.

ezpz

Ah, I didn’t see this comment when I replied to your other comment suggesting just that.

ezpz

Bummer. What a dilemma. Maybe you should contact your US senators and representative, as well as your state reps. Maybe the insurance commissioner, too? Hang in there and call, call call, which it seems you’re doing.

Ford Prefect

It’s a sad day when anyone can reasonably say CNN and Fox are better at anything at all and you’re quite reasonable. Griffin has his motivations and sound business practices and ratings apparently have nothing to do with his job. But hey, if someone offered me high six figures (or more) to run a rump propaganda organ with a shrinking audience, I’d probably have to think long and hard on that. I can’t fault them for going for easy money. Lavish pay in return for no real work product is a mediocrity’s dream!

ezpz

Oh bummer about the April thing. Hopefully, that will change for the better for you.

Ford Prefect

Not surprising. But do tell your story anyway. Put it in terms that people can recognize as not being an individual case, since individualization is the Number One way to dismiss people’s pain out of hand. It’s a policy-driven social problem. Hopefully others will also tell their stories.

ezpz

I agree that MSNBC is the pits when it comes to covering actual news, and Phil Griffin even admitted that they’re not too interested in doing breaking news. I see them as the Obama infomercial channel. Seriously.

And I also agree that when it comes to actual reporting and info, CNN & Fox are definitely better, and I have to say that Fox was the best on election night. Megan Kelly took no crap from Karl Rove. I think they were the first to report that Obama had won and Karly protested a bit, to put it mildly. She stayed calm and cool and even went to their information desk or whatever they call it only to confirm her original report.

Drew2u

Thanks, man. I’m in the middle of writing an email to my Senator about what I’m supposed to do. The other senator is a dumbass teabagger and I was gerrymandered out of my old representative into a teabagger district (even then, when my father contacted our old representative, he got back a letter essentially saying, “You’re not in my district; bye.”)

Ford Prefect

Indeed, they are the only ones talking up climate change every single day now. I’m impressed with their editorial shift on that.

Ford Prefect

But, but, states’ rights! Ugh. I wonder how many other people are in your situation. I’m guessing a huge number, over all those states. And what sayeth the White House? “It’s not my job, man.”

Anyway, posturing aside, I hope you can work something out. It’s increasingly difficult for me to not think we’re in a pre-revolutionary period. Too much pain is being inflicted on too many people in the name of pseudo-reform, with more Austerity already in the pipeline. Something’s gotta give at some point.

Drew2u

MSNBC changed its lineup over the past couple of years insomuch that the only palatable shows anymore are Martin Bashir, Ed Schultz, and Rachel Maddow. Andrea Mitchell was great, but she was pushed to, what, Saturdays?
If you want a good news station, watch the Weather Channel – seriously, I find their coverage of news stories to be fairly well done.

Drew2u

21 states outright rejected the Medicaid expansion money. Mine’s one of them. We don’t even have the hope that some of that money trickles down to us.

Drew2u

Thanks. It took me aback when, and I’m sure the nice lady on the other side of the phone was giving me her best educated guess, that someone who the Federal Exchange says is too poor to use the site but the State says is ineligible for State-level help must navigate the defective private insurance market (“thanks, Obama”?) by themselves without help from federal subsidies.
And the thing is, I probably could afford federal exchange insurance if I get the subsidies because the subsidies would knock prices down to almost $26/month for me for a silver-level plan (I can go back and redo the math if anyone wants).

Ford Prefect

The day I totally lost it is was when Hurricane Sandy was approaching NJ and I was trying to get information everywhere. So I’m on-line, while watching CNN, MSNBC and even Fox. Almost equally at first, to see how everyone was covering the story. Fox and CNN outdid MSNBC by miles by doing some actual reporting. MSNBC’s ONLY concern was, “How will SuperStorm Sandy effect President Obama?” Show after show, host after host, guest after guest. That was their concern.

It made me feel sick to my stomach.

Bill_Perdue

What they do at election time is fool those still willing to be fooled, and that number is dwindling.

Assuming that Democrats or Republicans agree with you is, unless you’re rich or right wing, usually just a political form of projection.

Ford Prefect

Given that the US spends twice what France spends per capita on “healthcare,” our sausage is the most expensive in the world and we get the 27th best system (just behind the Czech Republic and ahead of Latvia!) while France has the best by far.

Ford Prefect

What a (bleep)ing nightmare. This highlights the awfulness of devolving Medicaid to the states, rather than federalizing like they should have done. On top of that, how many states that are “expanding” Medicaid are going to pilfer some of those grants for other purposes?

And all of this can be sabotaged later because Austerity, since these are discretionary budget items. #FAIL.

Bill_Perdue

I would say incredible but I know better. Best of luck.

Drew2u

Yeah, Disqus does that from time-to-time, but I replied to your post as a general comment about genuine criticism of the Obama family / President Obama versus the fraudulent claims that the TEAOP/FOX make towards them (remember the attacks on Sasha and Malia?)
BTW, I don’t know if you’ve followed, but I added my own comment to this article updating my current status with the ACA. Long story short: Limbo until apparently April.

Bill_Perdue

Democrats and Republicans, the courts, Congress and the White House are all bitter and remorseless opponents of socialized medicine, single payer, the public option, Medicare for all or what ever name you give reformed health care.

Democrats, who control the Senate and the White House, and Republicans who run the House are not equally to blame. The Democrats hold the balance of power now and had total control in 2010 when, after secret meeting and massive bribes, they passed a Republican plan, Romenycare. Republicans have a health plan but it’s as bad as RomneyObamacare. Both embrace the fatal flaw of allowing insurance companies to control the health care of scores of millions.

The way to pressure Democrats and Republicans, who will control the next Congress is to subject them to the pressure of a massive movement for change. Than can be done through unions and by supporting pro-reform anti-insurance company groups like National Nurses United – http://www.nationalnursesunited.org – the fastest growing union in the AFL-CIO and determined critics of the Obama regimes health care sellout. Another group fighting for real reform is Physicians for a National Health Program – http://www.pnhp.org/ . And by demonstrations by disgusted consumers but that will have to wait until, or if, RomneyObamacare actually enrolls a lot of people.

One of the central points of Sicko is that private, for-profit companies will let patients die – i.e., murder them – if the cost of litigation is lower than the cost of an expensive procedure. The Obama regime and their RomneyObamacare scam will not end that practice. Who believes that Obama’s government will regulate that? Do they regulate BP in the Gulf? Do they regulate the banksters? Do they regulate polluters? Do they regulate mine safety and railroad safety?

You have your answer. They won’t regulate because they’re the lap dogs of big business.

Drew2u

If anyone’s taking Obamacare stories, here’s a continuation of mine. To recap: I enrolled on the ACA website and was told that I qualify for Medicaid. I called up the Federal site to enquire about what that means, they said to contact the state DHS. I contacted my state DHS early this month and they said to wait until the 18th to know if I got accepted onto my state’s medicare program. Between then and the 18th, my governor announces he’s not only not accepting Medicaid expansion money, but he’s putting on hold people like me’s applications, and holding off his plan of kicking a further 77,500 residents off of the state’s medicare program. The 18th passed and there’s no word, so I called the State back up.
Today: The State level said to contact the county level. I contacted the county level DHS to inquire about my medicaid status. They said that I won’t know until March or April because I’m in the group whose applications were put on hold. I asked about if I don’t get accepted, what are my options. The lady, as far as she was able to tell me, said that since the Federal exchanged kicked me to the state level, that I don’t qualify for the Federal exchange. I found this odd since I thought the point was that the Federal site would be available for anyone. I asked her what my options were, then, if the Federal level deems me ineligible and if my application is denied at the State level. She said my only other option was to go through private insurance. Since signing up for private insurance without the Federal exchange site means I can’t sign up for subsidies, I’m not exactly sure how I’m supposed to weed out the terrible plans and still afford an ACA-compliant plan.
Until then…. April fools, I guess?

ezpz

Okay. Maybe your reply was to a different comment, but it was placed right beneath the one with the thing about MO.
Disqus used to have more indentations for replies until they got to be one letter per line. Maybe that’s why they changed it to only indent once or twice, and beyond that, they’re all lined up so it’s sometimes hard to tell what reply goes to what comment.

Drew2u

Oh, you misunderstand me, I am not calling that site or that article made up or written by a RW/GOP website.
I’m stating that all the, “Go back to kenya! Hands off my medicare! Death panels! Socialist Marxist Stalinist Communist Hedonist! Benghazi Acorns!” official rhetoric coming from the GOP and from FOX, as seen by the freak show of a Republican Primary last election, goes to show their racism when there are true criticisms to make yet none of those criticisms are brought to light.

ezpz

That piece was not from a RW/GOP site. It’s from a very progressive one.
What part of it do you feel is made up?

ezpz

You might be right. I may have known and forgot…or just (re)learned it? Don’t remember. Information overload, I s’pose.
Besides, it seems that everything is subject to change according to the political whims and/or perceived (political) advantages of the administration.

Drew2u

Ya know, this really goes to show the racism of the GOP if, of all the faults the Obamas have, the GOP has to make up stuff in order to criticize the man.

Drew2u

I thought that was known? I guess it’s not necessarily a foregone conclusion.

ezpz

Is it possible to let the ACA stand until the next Congress and to reform it then?

I just had a crazy, funny thought. If the repubs were really smart, they would find a way to propose single payer. Of course, they’d have to call it and brand it as something else because their base, and even the blue dogs would never go for it. But just like Obama stole and marketed a conservative plan, the GOP could win on ‘stealing’ this progressive plan. I know it’s outlandish and will likely never happen. But sometimes it’s fun to delve into ‘what if’ territory. That would truly be a stroke of genius, which unfortunately for us, is something foreign to all of them – on either the D or R side of the corporatist aisle.

Whitewitch

That I did not know…should be published somewhere.

Indigo

I knew about that the way we know about so many things left on the back burner. You’re right, of course, the ACA is looking more and more like a sweetheart deal for the privileged and the insurance/hospital industry. A single payer medicare for all is where liberal and progressive opinion settled during the discussion that led up to the ACA. Somehow, it got scuttled. Now we need to un-scuttle it, so to speak. Is it possible to let the ACA stand until the next Congress and to reform it then? I’m hopeful but not optimistic. Unhappily, Barry gets in his own way and with Valerie in the WH scheming, I’m doubtful that this administration has anything left beyond inertia and the potential for vast scandal. I can only wonder what keeps the Obstuctionists from using these tools, they surely know about this.

ezpz

And speaking of those subsidies, I recently found out that if you purchase a policy directly from the insurance company rather than healthcare dot gov, you cannot receive any subsidies at all.

ezpz

What the racist pigs in the GOP hate most of all is that the national health insurance scheme is named after a black man. They can’t even write a speech without saying the name of a black president!

Speaking of MSNBC, this is exactly their shtick — If you don’t support him, you’re racist. That’s just lame and it’s getting old. But more importantly, it’s simply not true.

I don’t like this POS law, I don’t like Obama, but I’m hardly a racist. I was stoopid enough to vote for him in ’08 – NOT because he was black, but because I bought the hope hype.
I did NOT vote for him in 2012, and again, not because of his skin color, but rather because of the (lack of) content in his character.

The GOP loves to call it obamacare because it’s such a cluster f*&k and they want to associate it with him and more generally, the democrats. Politically speaking, that’s actually smart, not racist
Obama USED to like calling it that too, until all the problems started to manifest. Now, they (Ds) all call it the ACA.

Whitewitch

Oh dear…don’t be sad if you don’t get any down votes on this one dear friend. You are so totally correct and I think many of his previous supporters are losing hope that it will work out at hoped. I worry for those who must find money in their budget if they don’t qualify for subsidies.

MyrddinWilt

And that is where I think we might well end up.

What the racist pigs in the GOP hate most of all is that the national health insurance scheme is named after a black man. They can’t even write a speech without saying the name of a black president!

I bet that they will be willing to change to a public option if it means changing the name to Hilarycare because thats the way those pillowcase-heads roll.

ezpz

I try to tune in. I really do, but I don’t make it past one minute, IF that. They’re oh so predictable and just too grating on so many levels. Unwatchable.

ezpz

The only thing different at election time is that they will try harder to say what we want to hear, and will simply say it more often. Empty words.
I contacted them before election time with the promise that I would not vote for anyone who voted for the law. I kept that promise.

Badgerite

It isn’t really that complicated. The basic structure is the less you make, the more help you are entitled to from the state. You do have to be able to deal with a few numbers but that would be the case in any system but an out and out all free to everybody one. Medicare has its complications as well. Which have to be dealt with. I would have gone for the Canadian system, myself, but——- you get the sausage you can afford.

Ford Prefect

Given their massive slump in ratings, we are not alone in that department. I still tune in on occasion, but I change channel when I feel like I’m being trolled. That normally occurs within 10-15 minutes, regardless of the “show” I’m watching.

Ford Prefect

I do remember finding out what BO’s “community organizing” was about, pretty late in the cycle though. I didn’t know about MO’s chosen “profession.” It all makes so much sense in retrospect.

ezpz

And what amazes me even more is how he still has so many die-hard supporters who are willing and eager to defend the indefensible and spin on his behalf. I get dizzy just ‘watching’ them, which I try to avoid (never watch MSNBC anymore).

Ford Prefect

But that doesn’t mean we can’t make the demand. If “we” split ourselves over a non-existent sparkle pony like the PO, then we lose the initiative on Single Payer. This is why I’m so damn wordy in responding to notions of a PO. Okay, I’m wordy anyway.

If the demand isn’t there, then it won’t happen, as power concedes nothing without a demand.

http://adgitadiaries.com/ karmanot

Obama is a big time fraud in the tradition of Clinton.

http://adgitadiaries.com/ karmanot

It was all known-for years. but the glorious speechifying with a dollop of hope and change swept those carpetbaggers into office.

http://adgitadiaries.com/ karmanot

—-couldn’t agree more. Except for a few months around voting time, they could give a damn what we think.

http://adgitadiaries.com/ karmanot

Thank you Gaius for clarifying what many of us have been shouting out now for years—-Obama’s big law is an insurance boondoggle boom and a major fail. It never ceases to amaze me how Obozo runs in the opposite direction from greatness. It will be generations to recover from this feckless fraud of a president. ( O bots begin—-)

http://www.rebeccamorn.com/mind BeccaM

I agree. But alas — we’re not the ones doing the negotiating.

Ford Prefect

The public option looks good on paper at first glance, but it still means “reinventing the wheel” and would be very easy to sabotage through Austerity and other means.

Sometimes the radical thing to do is the best thing to do and Medicare For All would solve a Himalayan-sized mountain of problems with one fell swoop. Financing would be simple and off-budget, so Austerity can’t get its grubby mits on it. A Tobin Tax would be simple and painless (except for the TBTF banksters, appropriately enough). It would create a lot of good jobs providing actual healthcare to people, which is good economics in the midst of a depression.

Lastly, consider the opportunity that is opening up here. The old “system” was a national crisis. The “new system” is a total FAIL. And this FAIL in particular is simplifying and clarifying this issue for millions of people every day. We may not get another chance to make the point that healthcare is a right. Tinkering around the margins will not solve the larger problems, but it will help cement an already unjust system in place. And if we add in the fact that Obamacare is probably the template they’ll use to privatize SS and Medicare, then the stakes grow that much larger. The pols are freaked out because of what they have invested in their donor base. The donor base is freaked out because they see their Neo-Liberal project potentially crashing down.

This could be a decisive moment and if we negotiate this away in the name of “reasonableness,” we’ll pay dearly for it going forward. Sometimes we have to seize the moment given to us, even if it’s just the result of inane hubris on the part of others.

http://www.rebeccamorn.com/mind BeccaM

In my own research on the topic, time and time again the experts have said that the simplest, cheapest, and most efficient health insurance reform would have been (and still is) “Medicare for All.” Paid for by removing the cap on the payroll tax, getting rid of the money manager exemption, and imposing a miniscule tax on financial transactions.

In the meantime, even within the framework of PPACA, it would be a vast improvement if the gov’t offered a public option for insurance.

The other major reason for the far-right ACA result is Obama’s negotiation strategy – open with your opponent’s expected outcome then give away everything so they end up with 250% of what they initially expected.

Ford Prefect

I didn’t know that about MO. Perhaps it shouldn’t be surprising they were both in the business of stomping on poor people when they met. Healthy relationships include common interests and their chosen fields seem pretty well in line with each other. In the future, we should probably vet candidates more thoroughly before we put them in a position of power. Finding out all this so many years later is just embarrassing.

Ford Prefect

Outstanding, GP. One can only understand the institutional desire for “reinventing the wheel” from this vantage point, IMO. In this case, they reinvented a wheel with a flat tire and bent rim, that’s dangerous to drive on. So it’s no surprise it’s wrecking the car.

We are not “shoppers” or “customers.” We are human beings with a right to healthcare. PPACA deliberately denies us our agency in this matter. The only “fix” is to trash this POC and reduce the eligibility age for Medicare to zero. How many pages of congressional legalese would that require? Ten? The cover sheet listing co-sponsors should be eight of those pages.

ezpz

As I was rereading it, this paragraph, apropos to this tread, jumped out at me:

The First Lady played her own part in the Chicago racket of profiting off the poor. Michelle Obama worked at the University of Chicago Medical Center “redirecting” low-income patients to community hospitals in order to use its own beds for rich patients. Nick Jouriles, president of the American College of Emergency Physicians, released a statement saying the practice comes “dangerously close to patient dumping,” a practice made illegal by the Emergency Medical Labor and Treatment Act (EMTALA), and reflected an effort to “cherry pick” wealthy patients over poor.

I say ‘apropos to this thread’ because the glaring question is: how in the world can this monstrosity of a law be fixed when it has its roots planted firmly in the profit driven, private insurance industry? The obamacare networks are shrinking to exclude better, more expensive hospitals and doctors. Well, the rich will always be able to buy the best health care there is with or without insurance. The rest of us? Whole different story.

Sorry, but there is no fixing this. It needs to be scrapped and immediately replaced with single payer medicare for all. “Period.”

Ford Prefect

The first step in strategic planning is to answer the question: What are we about?

Universal Healthcare is a damn good answer and all else is tactics.

Ford Prefect

And that, by the way, is where Obama earned his chops as a “community organizer.” His job was to bamboozle poor Chicagoans into buying into a load of crap. At least he’s been consistent!

Ford Prefect

The GOP’s ire relates to the Donor Base. Dole-Romney-Obamacare was a GOP “product” largely intended to raise a ton of industry money. Obama “stole” it in their minds and they’re mightily pissed about that. On the flip side, the Dems stole it also to raise money from the Donor Base. That’s why they don’t mind the problems, as long as the corporate cash keeps flowing. Only a threat to their corporate fund raising would upset leadership.

And you hit the mark on this, as I don’t see any other point in this debacle:

In the end, the lesson is that neo-liberalism simply does not, and cannot, work. It’s long past time we put it aside.

Indigo

I didn’t know about that one but . . . oh! how surprising! [Not!]
When Chicago politics stinks, it reeks!

ezpz

You seem well informed, but in case you missed this one, here y’go:

How Obama and Valerie Jarrett Helped Launch Their Political Careers in an Outrageous ‘Urban Renewal’ Scheme

Developers and investors got rich on a project that destroyed the homes of thousands of Chicago’s poorest black residents.

Calling our senators and representatives is all well and good –BUT— what will be different now than it was when it was getting rammed through, progressive voices of reason be damned? I called and emailed my senators and representatives back than, and all I got was a form letter and the ‘privilege’ of being on their mailing lists. I did get some instant gratification when I unsubscribed with a scathing (and always politely expressed) reason for not wanting to hear from them again.

Don’t mean to throw cold water on good intentions, but the reality is that nothing will be different except perhaps for the few who are facing some imminent re-election challenges. They may be more ‘receptive’ to hearing the peoples’ voices of reason.

http://www.americablog.com/ Naja pallida

“Otherwise, it’s just private insurance.”

That’s one of the things I don’t get about the whole hair-on-fire from the right. The entire point of the Affordable Care Act is just private insurance. Yeah, it sets some parameters on what that insurance has to cover, but no matter how you twist it, there is nothing socialized about it. It isn’t a step to single payer, it’s a step towards privatizing more things in the same way. The entire onus to make the plan work has been foisted onto a for-profit system with a billions of dollars per year interest in seeing it not work. It doesn’t’ even make sense on the face of it, much less in some eleventy dimensional chess way.

Obama’s entire approach to the ACA, and pretty much his entire method of governing, is the exact opposite of “change we can believe in”. They have the hubris to think that they can play an irredeemably corrupt system from the inside, instead of making the effort to try and fix that system. They have repeatedly thrown most of their own base under the bus in the gamble that the private interests that puppeteer Congress will just give them what they want if they just ask enough times. By in large, it hasn’t worked out very well, except by accident. And you can pretty much guarantee all of Obama’s accomplishments will start to vanish the second Republicans have power again. Just like they did to much of what Bill Clinton did. In the end, the lesson is that neo-liberalism simply does not, and cannot, work. It’s long past time we put it aside.

Indigo

I blame Chicago society matron, failed White House social secretary and current White House Adviser Valerie Jarrett.

cole3244

again obama talks nice to the left but everything he does has the elites fingerprints all over it, we the constituency are only good at election time thereafter be seen and not heard is the wish of the wash establishment until the next cycle of course.

gratuitous

Very true, and marking for later when I can read it with a bit more concentration. Practically every time something is overly complicated, the answer is because somebody’s got their greedy little fingers in the till, dipping a little – or more likely a whole lot – more than their share. Doesn’t matter if we’re talking about the Affordable Care Act, Department of Defense procurement procedures, or the tax code, each and every complication and inefficiency built into the system profits some heavy hitter.

Thanks for enumerating a few of the players, and yes, let’s get about the job of fixing this system so that it inures more to the benefit of we the people and less to the benefit of grifters and middle men who always materialize to grab at a pot of money.

ronbo

I don’t know who this Gaius thinks he is… wait for it… wait… but we need more of him. Excellent piece. Goals set, now give me strategy. We have the grassroots within this community.